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BLUETAIL MEDICAL GROUP, LLC.
NPI 1285986398
Orthopaedic Surgery - Sports Medicine in Chesterfield, MO

Active since October 12, 2012CLIA 10D2202148 · Waiver
13353 OLIVE BLVD, CHESTERFIELD, MO 63017(636) 778-2900(636) 778-2828 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 17, 2025, Feb 2, 2021, Mar 20, 2018 and 1 more (4 updates tracked since 2016).

About Bluetail Medical Group, Llc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUETAIL MEDICAL GROUP, LLC. (NPI 1285986398) is a healthcare organization registered as a sports medicine in Chesterfield, Missouri and active in the NPI registry since October 2012. The organization holds a CLIA Waiver certificate valid through November 24, 2026, maintains 8 additional practice locations, and lists Joe O'neil, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1285986398
Entity TypeOrganization
Primary Taxonomy207XX0005X
Legal Business NameBLUETAIL MEDICAL GROUP, LLC.
Location Address13353 OLIVE BLVDChesterfield, MO 63017-3108
Mailing AddressPo Box 11665Belfast, ME 04915-4007 · (636) 778-2900 · Fax (636) 778-2828
Phone(636) 778-2900
Fax(636) 778-2828
Organization SubpartNo
Authorized OfficialJoe O'neilPractice Administrator · (636) 778-2900
Enumeration DateOctober 12, 2012
Last NPPES UpdateNovember 17, 20254 updates tracked since enumeration
NPPES CertifiedNovember 17, 2025
✔ NPI 1285986398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in MO · LC1262307
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Also ListedClinic/CenterTaxonomy 261Q00000X
13353 OLIVE BLVD, Chesterfield, MO 63017
Open in Google Maps ↗

Secondary Practice Locations 8

Location 1516 E State Road 32Westfield, IN 46074-8767 · Phone (636) 778-2900
Location 23852 Creamery RdDE Pere, WI 54115-9210 · Phone (636) 778-2900
Location 32807 W Broadway Ste 107Columbia, MO 65203-1317 · Phone (636) 778-2900
Location 4101 Hodencamp Rd Ste 102Thousand Oaks, CA 91360-5831 · Phone (636) 778-2900
Location 536 Old Kings Hwy S Ste 105Darien, CT 06820-4523 · Phone (636) 778-2900
Location 61575 Lookout DrNorth Mankato, MN 56003-2503 · Phone (636) 778-2900
Location 7160 Westmount DrFarmington, MO 63640-2970 · Phone (636) 778-2900
Location 81875 Veterans Park Dr Ste 2201Naples, FL 34109-0596 · Phone (239) 631-1960 · Fax (239) 631-5967

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2202148

Bluetail Medical Group, LLC · Naples, FL
Active · expires Nov 24, 2026
CLIA Number10D2202148
Laboratory TypePhysician Office
Certificate Effective DateNovember 25, 2024
Certificate Expiration DateNovember 24, 2026
Laboratory DirectorLuga Podesta
Laboratory Phone(239) 631-1960
Laboratory LocationBluetail Medical Group, LLC1875 Veterans Park Drive, Suite #2201, Naples, FL 34109
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAQUEL K RUSSO PA-C
Physician Assistant
13353 OLIVE BLVD
CHESTERFIELD, MO 63017
St. Louis County (636) 778-2900
DR. DAVID M CRANE MD
Emergency Medicine (Sports Medicine)
13353 OLIVE BLVD
CHESTERFIELD, MO 63017
St. Louis County (636) 778-2900
HILLARY DAWN GIBSON DPT
Physical Therapist
13353 OLIVE BLVD
CHESTERFIELD, MO 63017
St. Louis County (314) 200-4955
INTEGRATED MEDICINE AND CHIROPRACTIC REGENERATION CENTER O
Family Medicine (Sports Medicine)
13353 OLIVE BLVD
CHESTERFIELD, MO 63017
St. Louis County (314) 200-4955
DR. RONALD LEIGH PATRICK D.C.
Chiropractor
13353 OLIVE BLVD
CHESTERFIELD, MO 63017
St. Louis County (844) 699-4301
CYNTHIA DAVIS D.C.
Chiropractor
13353 OLIVE BLVD
CHESTERFIELD, MO 63017
St. Louis County (314) 200-4955
JULIE STUTKO FNP-C
Nurse Practitioner (Family)
13353 OLIVE BLVD
CHESTERFIELD, MO 63017
St. Louis County (314) 200-4955
DR. ERIC SIEGAL D.C.
Chiropractor
13353 OLIVE BLVD
CHESTERFIELD, MO 63017
St. Louis County (615) 473-8873

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bluetail Medical Group, LLC.'s NPI number?

The NPI number for Bluetail Medical Group, LLC. is 1285986398. It was assigned to this organization in the NPPES registry on October 12, 2012.

Where is Bluetail Medical Group, LLC. located?

Bluetail Medical Group, LLC. is located at 13353 Olive Blvd, Chesterfield, MO 63017. The listed phone number is (636) 778-2900.

What is Bluetail Medical Group, LLC.'s specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Does Bluetail Medical Group, LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2202148) is associated with this NPI, valid through November 24, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bluetail Medical Group, LLC. was last updated on November 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.